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目的探讨经尿道绿激光汽化术(PVP)联合阴囊单切口原位白膜下双侧睾丸切除术治疗中晚期前列腺癌致膀胱出口梗阻(BOO)的临床疗效。方法对21例中晚期前列腺癌患者应用(PVP)联合阴囊单切口原位白膜下双侧睾丸切除术,观察手术时间、术中出血量、术后留置尿管时间、手术并发症以及术前、术后IPSS、QOL、RU、Qmax、血清睾酮测定的差异。结果手术时间30～70(36.3±18.7)min,术中出血量20～70(36.3±21.2)mL,术后留置尿管时间3～7(3.6±1.7)d,术后患者全部随访3～20个月,未发现血行转移,1例行耻骨上膀胱造瘘术,20例排尿通畅,IPSS评分由(23.1±4.7)分降至(7.5±2.8)分,QOL由(4.3±0.8)分降至(2.5±0.7)分,RU由(75.3±25.3)分减少至(26.8±18.3)分,Qmax由(6.5±2.9)mL/s上升至(17.2±5.0)mL/s,血清T(87.5±6.5)ng/mL下降至T(45.7±7.0)ng/mL。结论 PVP联合阴囊单切口原位白膜下双侧睾丸切除术可作为治疗中晚期PCa的姑息性治疗措施。
Objective To investigate the clinical efficacy of transurethral green laser vaporization (PVP) combined with in situ subcapsular scrotal excision of scrotum single incision in treatment of bladder outlet obstruction (BOO) induced by advanced prostate cancer. Methods Twenty-one patients with advanced prostate cancer underwent bilateral suborbital orchiectomy undergoing bilateral suborbital oesophagectomy. The operative time, intraoperative blood loss, postoperative catheterization time, surgical complications and preoperative , Postoperative IPSS, QOL, RU, Qmax, serum testosterone differences. Results The operation time ranged from 30 to 70 (36.3 ± 18.7) min, the intraoperative blood loss was from 20 to 70 (36.3 ± 21.2) mL and the postoperative catheterization time was from 3 to 7 (3.6 ± 1.7) days. All patients were followed up for 3 ~ At 20 months, no hematogenous metastases were found, 1 case had suprapubic cystostomy and 20 cases had clear urination. The IPSS score decreased from (23.1 ± 4.7) points to (7.5 ± 2.8) points and QOL was (4.3 ± 0.8) points (2.5 ± 0.7) points, RU decreased from (75.3 ± 25.3) points to (26.8 ± 18.3) points, Qmax increased from (6.5 ± 2.9) mL / s to (17.2 ± 5.0) 87.5 ± 6.5) ng / mL to T (45.7 ± 7.0) ng / mL. Conclusion PVP combined with scrotal incision in situ bilateral suborbital orchidectomy can be used as a palliative treatment for the treatment of advanced PCa.